Nevada Medicaid and Nevada Check Up News (Third Quarter 2024 Provider Newsletter) [Read]

Attention Behavioral Health Providers: Monthly Behavioral Health Training Assistance (BHTA) Webinar Scheduled [See Web Announcement 2009]

Attention All Providers: Requirements on When to Use the National Provider Identifier (NPI) of an Ordering, Prescribing or Referring (OPR) Provider on Claims [Announcement 850]

If you are a Medicaid provider whose revalidation application has not been processed by your termination due date, you will be ineligible to provide services to any Nevada Medicaid or Nevada Check Up recipients, including both Fee-for-Service and Managed Care Organization (MCO) enrolled recipients. See Web Announcement 1265

Enrollment Termination Frequently Asked Questions (FAQs) [Review]

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Unwinding COVID-19 Information

Known System Issues-Click HERE

Paper claims are no longer accepted by Nevada Medicaid. Please refer to Web Announcement 1733 and Web Announcement 1829 for additional information.

Top 10 Claim Denial Reasons and Resolutions/Workarounds for September 2024 Professional Claims. See Web Announcement 3465.

Top Enrollment Return Reasons and Resolutions for January 2024 Submissions. See Web Announcement 3350.

Top Prior Authorization Denial Reasons for the Third Quarter of 2024. See Web Announcement 3488.

Attention Providers Using the Authorization Criteria Function: Results that return prior authorization (PA) requirements are accurate. For results that return “There are no records found based on the search criteria,” there may be a PA requirement if limits have been exceeded. To verify PA requirements, please refer to the Medicaid Services Manual (MSM) Chapter for your service type at dhcfp.nv.gov and the Billing Guide for your provider type at www.medicaid.nv.gov.

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Scheduled Site Maintenance

During the scheduled site maintenance window the Provider Web Portal will be unavailable. The table below shows the regularly scheduled maintenance window. All times will be in the Pacific time zone.

Monday - Friday
12:00AM - 12:30AM

Monday
8:00PM - 12:00AM

2018 P&T Pharmacy Meetings

Notice Date Title
November 2018 For Review at November 15, 2018, Meeting: Attention-Deficit/Hyperactivity Disorder (ADHD) Agents
November 2018 For Review at November 15, 2018, Meeting: Anticonvulsants
November 2018 For Review at November 15, 2018, Meeting: Multiple Sclerosis Agents
November 2018 For Review at November 15, 2018, Meeting: Opioid Use Disorder Agents
September 2018 For Review at September 27, 2018, Meeting: Alpha-Glucosidase Inhibitors
September 2018 For Review at September 27, 2018, Meeting: Alzheimer’s Disease Agents
September 2018 For Review at September 27, 2018, Meeting: Anticoagulants, Injectable
September 2018 For Review at September 27, 2018, Meeting: Anticoagulants, Oral
September 2018 For Review at September 27, 2018, Meeting: Antifungals, Topical
September 2018 For Review at September 27, 2018, Meeting: Antihistamines, Second Generation
September 2018 For Review at September 27, 2018, Meeting: Anti-migraine Agents (Triptans)
September 2018 For Review at September 27, 2018, Meeting: Antipsoriatic Agents
September 2018 For Review at September 27, 2018, Meeting: Antivirals, Herpes
September 2018 For Review at September 27, 2018, Meeting: Antivirals, Influenza
September 2018 For Review at September 27, 2018, Meeting: Benign Prostatic Hyperplasia Agents
September 2018 For Review at September 27, 2018, Meeting: Beta-adrenergic Blocking Agents
September 2018 For Review at September 27, 2018, Meeting: Bone Density Regulators
September 2018 For Review at September 27, 2018, Meeting: Electrolyte Depleters
September 2018 For Review at September 27, 2018, Meeting: Erythropoiesis Stimulating Agents
September 2018 For Review at September 27, 2018, Meeting: Fluoroquinolones
September 2018 For Review at September 27, 2018, Meeting: Immunomodulators
September 2018 For Review at September 27, 2018, Meeting: Incretin Mimetics and Amylinomimetics
September 2018 For Review at September 27, 2018, Meeting: Inhaled Aminoglycosides
September 2018 For Review at September 27, 2018, Meeting: Inhaled Anticholinergics
September 2018 For Review at September 27, 2018, Meeting: Inhaled Beta-Agonist Combination Agents
September 2018 For Review at September 27, 2018, Meeting: Inhaled Beta-Agonists
September 2018 For Review at September 27, 2018, Meeting: Inhaled Corticosteroids
September 2018 For Review at September 27, 2018, Meeting: Ophthalmic Antibiotic Steroid Combinations
September 2018 For Review at September 27, 2018, Meeting: Ophthalmic Antibiotics and Combinations
September 2018 For Review at September 27, 2018, Meeting: Ophthalmic Antihistamines
September 2018 For Review at September 27, 2018, Meeting: Ophthalmic Immunomodulators
September 2018 For Review at September 27, 2018, Meeting: Otic Antibiotics and Antibiotic-Steroid Combinations
September 2018 For Review at September 27, 2018, Meeting: Pulmonary Arterial Hypertension Agents
September 2018 For Review at September 27, 2018, Meeting: Statins (HMG-CoA Reductase Inhibitors)
June 2018 For Review at June 28, 2018, Meeting: Antiemetics
June 2018 For Review at June 28, 2018, Meeting: Incretin Mimetics & Amylinomimetics
June 2018 For Review at June 28, 2018, Meeting: Insulin and Combination Agents
June 2018 For Review at June 28, 2018, Meeting: Ophthalmic Prostaglandin Analogs
March 2018 For Review at March 22, 2018, Meeting: Antiasthmatic – Monoclonal Antibodies
March 2018 For Review at March 22, 2018, Meeting: Inhaled Beta-Agonist Combination Agents
March 2018 For Review at March 22, 2018, Meeting: Inhaled Corticosteroids
March 2018 For Review at March 22, 2018, Meeting: Intranasal Corticosteroids
March 2018 For Review at March 22, 2018, Meeting: Omega-3 Fatty Acids
March 2018 For Review at March 22, 2018, Meeting: Opioids, Long Acting
March 2018 For Review at March 22, 2018, Meeting: Renin Inhibitors and Combinations
March 2018 For Review at March 22, 2018, Meeting: Sodium-Glucose Cotransporter 2 Inhibitors
March 2018 For Review at March 22, 2018, Meeting: Statins (HMG-CoA Reductase Inhibitors)